他汀类药物可降低无症状颈动脉内膜切除术患者的神经损伤。
Statins reduce neurologic injury in asymptomatic carotid endarterectomy patients.
机构信息
Department of Anesthesiology, Columbia University, New York, NY, USA.
出版信息
Stroke. 2013 Apr;44(4):1150-2. doi: 10.1161/STROKEAHA.111.000362. Epub 2013 Feb 12.
Abstract
BACKGROUND AND PURPOSE
Statins are neuroprotective in a variety of experimental models of cerebral injury. We sought to determine whether patients taking statins before asymptomatic carotid endarterectomy exhibit a lower incidence of neurological injury (clinical stroke and cognitive dysfunction).
METHODS
A total of 328 patients with asymptomatic carotid stenosis scheduled for elective carotid endarterectomy consented to participate in this observational study of perioperative neurological injury.
RESULTS
Patients taking statins had a lower incidence of clinical stroke (0.0% vs 3.1%; P=0.02) and cognitive dysfunction (11.0% vs 20.2%; P=0.03). In a multivariate regression model, statin use was significantly associated with decreased odds of cognitive dysfunction (odds ratio, 0.51 [95% CI, 0.27-0.96]; P=0.04).
CONCLUSIONS
Preoperative statin use was associated with less neurological injury after asymptomatic carotid endarterectomy. These observations suggest that it may be possible to further reduce the perioperative morbidity of carotid endarterectomy. Clinical Trial Registration- URL: http://www.clinicaltrials.gov. Unique identifier: NCT00597883.
摘要
背景与目的
他汀类药物在多种脑损伤的实验模型中具有神经保护作用。我们旨在确定在无症状颈动脉内膜切除术（CEA）前服用他汀类药物的患者是否会降低神经损伤（临床中风和认知功能障碍）的发生率。
方法
共有 328 名患有无症状颈动脉狭窄并计划接受择期 CEA 的患者同意参与这项关于围手术期神经损伤的观察性研究。
结果
服用他汀类药物的患者临床中风的发生率较低（0.0% vs 3.1%；P=0.02）和认知功能障碍（11.0% vs 20.2%；P=0.03）。在多变量回归模型中，他汀类药物的使用与认知功能障碍的几率降低显著相关（比值比，0.51 [95% CI，0.27-0.96]；P=0.04）。
结论
无症状颈动脉内膜切除术前使用他汀类药物与术后神经损伤减少相关。这些观察结果表明，可能有可能进一步降低颈动脉内膜切除术的围手术期发病率。临床试验注册- URL：http://www.clinicaltrials.gov。独特标识符：NCT00597883。
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